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I feel obligated to express my disappointment with your decision to publish the original contribution by Rafael Zegarra-Parodi, DO (England), MEd, and coauthors (2009;109:79-85).

I would like to believe that the JAOA is “the premier scholarly publication of the osteopathic medical profession,” as you clearly state in the introduction to the Letters section of The Journal. However, the article by Zegarra-Parodi et al is written by foreign-trained osteopaths who are not licensed osteopathic physicians (as I understand the credentials), and it does not represent my profession. I would have hoped, at least, that the following statement by the authors would have been edited to correct the inaccuracy that osteopathic physicians practice a cranial manipulation “technique” rather than an applied science of osteopathy in the cranial field: “Cranial manipulation, or craniosacral therapy, is a widely practiced technique used by osteopathic physicians, foreign trained osteopaths, chiropractors, physical therapists, and massage therapists.”

I hold a masters of science degree in physical therapy from the University of California at San Francisco, and I am a certified athletic trainer. I am also a third-year osteopathic medical student at Touro University College of Osteopathic Medicine—California in Vallejo. If there had been no need for me to attend osteopathic medical school to learn my profession, and if I could have achieved my goals by simply being trained in a cranial manipulation technique, I would have saved myself many years of study and financial strain. However, before I became an osteopathic medical student, I tried that route, attending numerous courses in craniosacral therapy offered to nonphysicians. Even as a physical therapist who was trained at one of the premier schools in the United States, I felt a gap not only in the quality and skill of my delivery of the techniques, but also in the results I observed in my patients.

The reality is that treatment using cranial manipulation is not a technique to be learned and then practiced. Instead, in training to become an osteopathic physician, many aspects of anatomy, physiology, neurology, cellular biology, biochemistry, and biomechanics must first be learned as a basis before one can practice osteopathy in the cranial field. That is the main difference between osteopathic physicians and the other professions that the authors so blindly clumped together in the previously mentioned statement.

The road to becoming an osteopathic physician is long for a good reason. I and other osteopathic medical students study the complex sciences that help us understand the amazing biologic processes of the human body so that we can then use the marvelous tool of osteopathic medicine as a complete science—not merely as a technique—to help our patients. I urge the JAOA to keep these points in mind and to respect the chosen paths and dedication of all osteopathic medical students by better guarding the distinctiveness of the osteopathic medical profession.